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Q1. A 60-year-old female presents with alkaline reflux gastritis after Billroth I gastrectomy. What is the ideal management?
Answer
Answer: b
Explanation: Roux-en-Y is preferred to prevent bile reflux. A Roux limb (~60 cm) reduces symptoms like epigastric pain, bilious vomiting, and weight loss. HIDA scan can confirm diagnosis.
Ref: Sabiston, SKF
Q2. A 58-year-old male with Type I bleeding gastric ulcer unresponsive to endoscopy. Best treatment?
Answer
Answer: c
Distal gastrectomy with Billroth I is ideal for bleeding Type I ulcers. Oversewing or wedge excision is for frail patients.
Ref: Sabiston
Q3. Which statement is NOT true about H. pylori?
Answer
Answer: a
H. pylori is more prevalent in developing countries. It’s spiral-shaped, flagellated, and transmitted mainly via oral-fecal route.
Q4. Which hormone is NOT released in the duodenum?
Answer
Answer: d
Peptide YY is secreted from the ileum. Gastrin, motilin, and somatostatin are released in duodenum or stomach.
Q5. What is the treatment for bleeding duodenal diverticulum?
Answer
Answer: a
Diverticulectomy is first-line treatment. If near ampulla, subtotal diverticulectomy is safer.